Environmental Health

Asthma ER Visits And Hospitalizations Drop In Many Communities

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The rates of asthma-related emergency room visits and hospitalizations dropped in many Connecticut communities, the latest data from the state Department of Public Health show. Overall, 58 percent of communities saw a decrease in the age-adjusted rate of emergency room visits, while 63 percent saw a decrease in the rate of hospitalizations for asthma, according to a C-HIT analysis of the data. Some 36 percent saw improvement in both areas. The data compares age-adjusted rates for each town for 2005-2009 and for 2010-2014 per 10,000 people. Meanwhile, the state’s overall rate for emergency room visits in 2014 was lower than recent years but still was higher than it was 10 years ago.

Patient Safety

Report: IT Systems, Patient ID Errors, Top Issues For Health Care Organizations

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Health care organizations’ information technologies and workflows often don’t support each other, according to a patient care-focused nonprofit that flagged the problem as one of the top safety issues facing the industry. The ECRI Institute, which recently released its third annual ranking of the Top 10 Patient Safety Concerns for Healthcare Organizations, reported that patient identification errors and inadequate management of behavioral health issues in non-behavioral health settings were its No. 2 and No. 3 issues for health care organizations. When a health IT system is introduced, health care organizations should tailor it to their workflow, and vice versa, according to ECRI, which is based in Pennsylvania.

Outpatient Care

Outpatient Facility Fees To Be More Transparent With New Law

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Patients billed for a facility fee for outpatient hospital services will get a clearer explanation of the charge, under legislation taking effect Friday. Connecticut has taken various steps to educate patients about the fees. The latest changes, passed this year as part of a broader health care bill, put further mandates on institutions that charge the fees. Patients have complained they were blindsided by the fees on their medical bills, and patient advocates say the fees are difficult to understand. A facility fee is charged by a hospital or health system for outpatient services provided in a hospital facility, intended specifically to compensate the facility for operational expenses.

More Than 90 Percent Of CT Hospitals Face Readmissions Penalties

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All but one of Connecticut’s acute-care hospitals will lose Medicare reimbursement in 2015-16 as a penalty for high readmissions of discharged patients, new federal data show. The penalties against 28 hospitals mean Connecticut has one of the highest percentages nationally – more than 90 percent — of hospitals facing Medicare reductions. Only the Hebrew Home and Hospital of West Hartford escaped penalties; the Connecticut Children’s Medical Center is exempted from the federal program. None of the state’s hospitals faces the maximum 3 percent reduction to Medicare reimbursement, but seven face reductions of more than 1 percent. They are: Milford Hospital (1.70 percent); Middlesex, in Middletown (1.38); Johnson Memorial, in Stafford Springs (1.27); Charlotte Hungerford, in Torrington (1.19); St.

Disparities

Efforts Underway To Increase Access To Hospital Infections Data

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A state lawmaker who is pushing public health and hospital officials to make data on hospital infection rates available to consumers, in the wake of a C-HIT story, says he is “encouraged” by a new website on hospital quality launched by the Department of Public Health (DPH) Office of Health Care Access. But state Sen. Tony Hwang, R-Fairfield, said he still wants to work with DPH and state hospitals to make the infection rate information more easily accessible. DPH recently launched a website application, developed by the federal Department of Health and Human Services’ Agency for Healthcare Research and Quality, that provides information on quality and utilization measures, including hospital-acquired infections, for each Connecticut hospital. “I think it’s a very good start, and I appreciate (DPH Commissioner) Dr. Jewell Mullen recognizing that the data should be made available,” Hwang said. “But I still think we need to find ways to make that information more easily available,” possibly through disclosures on individual hospitals’ websites, he said.

I-Team In-Depth

Connecticut Nurse Among Highest Prescribers In U.S.

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A Derby nurse practitioner was among the top 10 prescribers nationally of the most potent controlled substances in Medicare’s drug program in 2012 – an anomaly in a state where Medicare records show nurse practitioners rarely prescribe such drugs, which have a high potential for abuse. Heather Alfonso, an advanced practice registered nurse (APRN) at the Comprehensive Pain & Headache Treatment Centers, LLC, wrote out 8,705 prescriptions for opioids and other Schedule II drugs in 2012 – the most prolific prescriber among all Connecticut practitioners, including pain specialists and other physicians, according to Medicare data compiled by ProPublica. She wrote out more prescriptions for the opioid Exalgo than any other Medicare provider in the country, and was the seventh highest prescriber nationally of Oxycontin, writing out more than twice as many prescriptions for that narcotic as the next highest prescriber in Connecticut. She also was the 10th highest prescriber nationally of Avinza, a morphine product. There is no indication that Alfonso’s unusual prescribing frequency drew scrutiny from state or federal officials.

I-Team In-Depth

Hospital Reports Of Surgical, Medication Errors Climb

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Connecticut hospitals reported record numbers of patients killed or seriously injured by hospital errors in 2013, with large increases in the numbers of falls, medication mistakes and perforations during surgical procedures, a new state report shows. The report, covering 2013, marks the first time that the number of so-called “adverse events” in hospitals and other health care facilities has topped 500 – double the number in 2012, when 244 such incidents were reported. Much of the increase was due to an expansion of reporting on pressure ulcers, which added a new category with 233 “unstageable” ulcers that were not counted before. Even without that category, however, reports of adverse events climbed 20 percent over 2012. The most significant increases were in the numbers of patients harmed by foreign objects left in their bodies after procedures – doubling from 12 to 25 in one year — or those harmed by perforations during surgical procedures – 79, compared to 55 the previous year.

I-Team In-Depth

Operating Profits Drop At State Hospitals: New Report

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Connecticut’s acute-care hospitals saw gains from their operations tumble 35 percent in the last fiscal year, with seven of 29 hospitals reporting operating losses, according to a new state report. While hospitals still ended the year with $597 million in profits overall, the report by the state Office of Health Care Access (OHCA) raises concerns that non-operating revenue, such as income from investments, was masking the decline in operating revenue. “While hospitals’ operational financial performance weakened in FY 2013, they continued to generate significant non-operating gains, helping to keep overall hospital financial performance strong,” the report says. “However, a robust financial picture should rely more on patient and other operating revenues, and not on a less than reliable income source, such as investment performance.”

Hospitals’ profits from operations dropped to $333.6 million, from $513.5 million in the 2012 fiscal year. At the same time, hospitals earned $70 million more from investments, charitable contributions and other sources of revenue.

I-Team In-Depth

Should You Take The Health Care Tax Hit?

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Time is running out for thousands of uninsured Connecticut residents who must decide whether to comply with a federal mandate to buy health insurance starting Jan. 1, 2014 or pay a penalty instead. “We are undertaking a paradigm shift in how we think about health insurance,” said Dan M. Smolnik, a tax attorney from Brookfield. “We don’t know for sure how people in Connecticut will respond. But I think the majority will weigh the risks of not having health insurance and make a rational decision that isn’t purely based on economics.

Fines & Sanctions

CT Fails Consumers Looking For Health Care Costs

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Connecticut was among 29 states nationwide to earn an “F” from health advocates for lacking consumer-friendly laws that help residents compare actual prices for health care procedures and services. “There is no public resource in Connecticut that makes (comparison) pricing information available to consumers. That means there’s no consumer protection against egregious pricing behaviors by providers,” said Francois de Brantes, executive director of the Health Care Incentive Improvement Institute in Newtown, which partnered with Catalyst for Payment Reform to publish the “Report Card on State Price Transparency Laws.”

The Report Card’s scores reflected a state’s overall legislative effort toward health care price transparency, with states that post price information on a public website receiving more points than those that release a report or provide data to consumers only upon request. The organizations that developed the report card are nonprofits that support payment reforms to increase the quality and value of health care. Ellen Andrews, executive director of the Connecticut Health Policy Project, said, “The score is totally warranted.